<div class="row">
    <div class="col-xs-12">
        <div class="panel panel-midnightblue">
            <div class="panel-heading"><h4>会员借卡</h4></div>
            <div class="panel-body">
                <form action="" class="form-horizontal row-border"  data-validate="parsley" id="validate-form">
                    <div class="form-group">
                        <label class="col-sm-3 control-label" for="name">会员姓名:</label>
                        <div class="col-sm-6">
                            <input type="text" readonly name="name" class="form-control" value="{$model.name}">
                        </div>
                    </div>
                    <div class="form-group">
                    		<label class="col-sm-3 control-label" for="nick_name">会员电话:</label>
                    		<div class="col-sm-6">
                    			<input type="text" readonly  class="form-control" id="mobile" value="{$model.mobile}"/>
                    		</div>
                    </div>
                     <div class="form-group">
                    		<label class="col-sm-3 control-label" >原来卡号:</label>
                    		<div class="col-sm-6">
                    			<input type="text" readonly   class="form-control"  value="{$model.card_no}" />
                    		</div>
                    </div>	
                    <div class="form-group">
                    		<label class="col-sm-3 control-label" >会员借记卡号:</label>
                    		<div class="col-sm-6">
                    			<input type="text" placeholder="请将卡放到读卡器上" data-minlength="5" name="card_no" class="form-control" id="card_no" />
                    		</div>
                    </div>
                   <input type="hidden"  value="{$borrow_card_no}"  id="borrow_card_no" />
                </form>
            </div>
            <div class="panel-footer">
                <div class="row">
                    <div class="col-sm-6 col-sm-offset-3">
                        <div class="btn-toolbar">
                            <button class="btn-primary btn" id="form-submit">提交</button>
                            <button class="btn-default btn" data-dismiss="modal">关闭</button>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
<script type='text/javascript' src='{$Think.ADMIN_VIEW_JS}member/back.js'></script>